Tag: abuse

Nope, blood ties do not entitle or excuse you.

For those of you that have read my autobiography, Me Myself and My Story, you already know that there is whole lot of family issues, abuses, tragedies, mental health trouble that has flowed freely throughout my life. Having said all that, I still am grateful that I have turned out the way that I did and I am proud of the person I choose to be. Part of the point of writing that autobiography was not to be a vengeful tell all, it was hopefully to point out that any person still possesses the right to choose a better direction somehow if they want to. I like to think that I am a prime example of that.

Having said that, yes, there have been multiple family members that I have not been close to for years for various reasons. Some of them took in negative input fed to them by others with no opportunity for me to repute it. I didn’t even know that was going on in the first place. Fortunately a lot of those folks have come around and are now in my life again and I am very grateful. There were a lot of years wasted and missed though.

To add to this, I realize that I have done things that have upset people. In my perspective, those things were done with a purpose and intention for good and for protection. I have sent people to prison for abuse. I have spoken my mind at public gatherings. I have dismissed certain people from my life when their level of toxicity crossed the boundary that I had set and was literally compromising my mental and physical health. I do not regret any of these actions. They are what I had to do to protect myself and my family. I have to admit, I do not understand those who force themselves into family holidays and gatherings despite a long history of abuse and mistreatment. I am not sure if they feel that they don’t have any choice or if they are supposed to because there are blood ties involved. Either way, it only allows further damage and abuse to continue. I have seen many people dismiss past wrongs with no concrete apology or resolution. I understand that forgiveness is divine, but for myself, I need at least a little actualization that it happened in the first place or even the two little words “I’m sorry.” for that to be enough for me to re-interact. I feel like that is a minimum requirement to say the least. I have come to realize the phrase friends are the family that you chose is quite accurate. As much time as I have struggled to maintain family relationships, I have not noticed all the friends and non-toxic family members that are right there waiting to spend time with me. This is something that I have vowed to strive better for in my future. This is a plan that I am going to stick with.

I just want to end this explaining myself session with some words of advice and self-advocacy. No blood ties justify or excuse terrible or abusive behavior. It is within your power to seek out non-toxic relationships for the benefit of yourself and your mental health. It is sometimes a very difficult decision, but is definitely the healthier one.

Have a peaceful day.

Dr. Katz

Do you actually understand what addiction or substance abuse disorder means?

I just had a long term former substance disorder patient turned warrior and full fledged citizen of llife and family and work. She spent years on crack cocaine and it destroyed her life, her job options, her home, her family, and her health. Her once bright appearance became unrecognizable. The good news is that three years ago now, with prompting by her parents who had not yet given up on her, offered her a place to live in exchange for getting help. You know what, she got that help and three years later she is independent, has her own apartment, and her own job and comes into my office smiling with make up on. It is amazing to witness.

it really got me to thinking a lot about addiction and substance abuse disorder. I thought about all the misconceptions that I have heard about it and all the judgement that I have heard about it. Let me take a minute to explain what it really is.

Sadly I have a lot of personal experience with this with patients and I make it a point to listen to their stories in detail, always hoping that I can grab something from one of them that could be used to inspire another patient in trouble.

Let’s first define addiction. The definition of addiction is the fact or conditions of being addicted to a particular substance, thing, or activity. I know, using a word to define itself right? An addiction can also be referred to as a dependence, craving, habit, weakness, compulsion, fixation, or enslavement to a particular substance, thing, or activity. You get the point though, correct? It implies an unhealthy deep attachment to anything.
Now let’s talk about substance abuse disorder. the definition of substance use disorder is the persistent use of drugs despite substantial harm and adverse consequences to oneself and or others. This often described in laymen’s terms as drug or alcohol abuse.

So, you see they both go together. They can’t really exist without each other, but yet they are not the same thing.

Theses are devious bad buddies people. When people often think of addiction, they get either judgy or uncomfortable. They tend to be afraid of or look down on those patients and people, either because they just don’t understand it or they have had some personal bad experience.

I get it, if you have been the victim of a crime perpetrated by someone under the influence of drugs or alcohol, it can be both terrifying and very serious and something that it hard to get. Short of that, most of the judging or condescending toward addiction patients is just a lack of understanding,

This is not me saying that there are basic codes of conduct that should be followed by any human being. No. Not at all. I am just trying to make sure that this particular disease is better understood.

Wait? Did I say disease? Yep I did. Addiction is truly a form of disease with multiple components not unlike diabetes or hypertension. You could tell yourself, there is no way that someone made a choice to be diabetic or hypertensive and an addicted person did! Well, actually, in a way, genetics aside, sometimes people have made choices to gain weight or make other unhealthy decisions that led them to those diagnoses in the first place and once the anatomical changes are in place, serious measures have to be taken to attempt to correct them and ensure a longer life.

Well, whaddya know. The same kind of principles apply to addiction. Addiction has multiple components. There may in fact be a genetic susctibility. There may be environmental factors. There may be stimulating traumas that lead people to try to find a mental way out and they pick the worst one. Last time I checked, no addicts that I have come to know just sat down one day and decided to shoot up heroin out of nowhere. That initial terrible decision came from a variety of different sources and triggers the majority of the time.

Like with any disease, once addiction has rooted itself in the brain, it literally changes the brain anatomy, It literally causes the formation of a whole new shortcut pathway of dopamine to the nucleus accumbens in the brain. This decreases and intensifies the perception of the pleasure response, while also shortening the duration at which it lasts. This is a terrible double-edged sword and even for those who maintain recovery status, there is a risk of that new path always being there, hence the forever fight against cravings and temptation.

Like with any disease, it requires a certain level of readiness before recovery can even become an entertainable option, just like hypertension and diabetes. I have patients every day that are not ready to actualize that they have these conditions and it is incredibly difficult to help them until they are ready. Unfortunately, addiction carries the extra weight of ruining all the patient’s relationships and job opportunities all around them so many people suffer, not just the patient. That is a way that addiction is definitely worse and potentially more powerful.

My whole point and the most important bottom line is to offer a least a slight pause of understanding for the addicted patient. They do need help and hopefully they are willing to receive it. They have to understand going in that it will require a lifetime of strength, resistance and fortitude. It is not a job or a task that is completed in a day. There are multiple steps every single day to keep the train on track so to speak. It is no easy task, but it can potentially save their lives.

Have a great day everyone. There are potential heros at heart everywhere.

Dr. Katz

Feel like there are no options left? I am telling you that there are. Let’s discuss it right now.

What I am talking about is violence and abuse. Yes, that’s right, Violence and abuse, whether it be toward you, your kids, your relatives or whoever. It is everywhere and increasing every day. I am faced with an ever-increasing amount of patients who are facing this issue regularly.

So, what’s the worst that could happen? Well, someone could actually end up dead or permanently damaged in some way for one. Dead. Never coming back. Dead. Someone could end up permanently emotionally damaged and use that as an excuse to continue that style of behavior and life even into their next phase of life or worse, if they were an abused child or spouse, continue on to abuse their children or next spouse because that is the scenario they are familiar with or they are using that as their excuse. The things that I hear the most is ” I just don’t know what to do. or…That’s how I was brought up…or..That’s the same stuff I went through….or….It’s all I know.

These are the most heart breaking responses I ever here. I picture in my mind the terrified children or the terrified spouse or girlfriend. When there is abuse going on, everyone suffers, not just the person actually undergoing the abuse. It has wide ranging, awful ripple effects. Too often I am trying to work with someone that has already given up and just figures that there is nothing they can do and that is just the way that it is.

I am here to tell you that that is not true. Despite what you think, there are always possible options, if you chose to take them. They require fortitude, strategy, secrecy, and sometimes heartbreaking techniques, but they can be done. I refuse to believe that there is no option. Before I go any further, I need to tell you that I personally have had more than my fair share of abuse and violence in my past. I had to keep secrets that no one should have to keep. I had to live through things that no one should have to live through. So, I get it. There is no easy way out. Finally, as an adult I try my best to live a healthy life and be a good parent to my kids and be a good wife to my husband and break the former cycle. I am telling you there is a way to make it stop and move forward, even if there is no one that you currently know who can show you.

First, before you even get started you have to give yourself a moment of calm to begin planning. You need to have a relocation plan, even if it is to a safe house or local shelter. You need to set aside a separate source of funds. You need to get your papers in order. You need to be willing to stop and accept and sacrifice yourself or worse, your children as if you somehow deserve it. NO ONE deserves abuse. NO ONE! You need to value yourself and your kids enough to get the heck out of there before something irreparable happens. If it is safe to do so, you need to stand up to that partner or spouse and say look, my poor heart may love you for the rest of my life but my children and I cannot live with you another day if this crap keeps going on. If it is not safe to do that, then just get the heck away while you can and figure the rest out later. Nothing is worth risking your life, your childrens’ lives, or your mental health to stay.

I am telling you that it can be done. You can get away. You can begin to live a healthy life again. Please do not use your experiences as an excuse to re-enact the same poor behaviors to others or your kids. Please do not inadvertently teach your children that abuse is ok and that there is nothing you can do. I am living proof that it is possible. Here is the link to the National Domestic Violence Hotline. Please use it if you need it. They offer support in over 200 plus languages.

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1-800-799-7233

Dr. Katz

What is a healthy relationship?

Ok I am going to say it. My husband truly is my best friend, but what does that actually mean? Are there different criteria for besties you are married to versus ones that you are not married to or in a relationship with? I don’t actually know the answer to this one, but I can define what I mean when I say it. I mean that my husband is the first person I think of to talk about my day with, to tell a secret to, to giggle with, to hold hands with, to spend the day with, or to just sit and do nothing with. He really is at the top of the list. I still get a stupid smile on my face( most of the time) when I think of him or refer to him in conversation. We still have a lot of fun. That’s my definition of a best friend. This does not mean that we never fight or argue, but we have never resorted to hitting or any other violence. This does not mean that sometimes I don’t get so pissed off at him that I don’t want to speak to him for awhile. Both spectrums are fully represented. No one can make me happier and no one can make me angrier. Gladly, these two situations don’t usually present at the same time, if you don’t count menopausal hormone swings. I still have other friends and I still lead my own independent life with my own goals and pursuits. I travel alone for business or with friends sometimes. I “do my own thing.” He is not up my proverbial butt all the time. I still consider that pretty normal and healthy.

Sometimes when people say those words, they mean something entirely different and, in my opinion, not so healthy. I know people who talk about their partners being their best friends and what I see, as an outside observer, is a relationship that is fraught with obsession, possession, and pathologic co-dependence. They are attached at the proverbial hip with their partners. They identify themselves only as a matched set. They are uncertain of who they are when their partner is not around. They have no outside friends or unshared activities. They have a habit of checking/seeking permission from their partner to do anything. They don’t speak their minds for fear of starting an argument. To me, this is unhealthy and potentially leads down a slippery slope to a controlling or even abusive relationship. I get that traditionally we think of an abusive relationship in terms of physical abuse, but emotional abuse leaves just many scars and they last longer.

So, what is a healthy relationship? I find that this is a question that seems to be getting more and more difficult to answer for both adults and adolescents. Did you know that roughly 1.5 million high school boys and girls in the U.S admit to being intentionally harmed or abused in a relationship at one point and that 1 in 3 young people will be in an abusive or unhealthy relationship at some point in their lives. That means that 33% of adolescents in America are victim to sexual, physical, verbal, or emotional dating abuse. This behavior is starting as young as six th grade! Young women who are in an abusive relationship are 6 times more likely to become pregnant or contract a sexually transmitted infection and are 50% more likely to attempt suicide. Add on top of this that most of this abuse goes unreported because of fear of exposure or just lack of knowledge about possible recourse. The stats for adults are not any better in terms of unhealthy relationships. Did you know that a woman is assaulted or beaten every nine seconds in the United States. 1 in 3 women, and 1 in 4 men, have been in abusive relationships. 1 in 5 women and 1 in 7 men have faced severe physical violence as well. 20 people are abused by an intimate partner every minute, which adds up to 10 million people each year. Just like with the teens, up to 75% of this is not reported.

Ever time I look at those statistics, I am sobered once more about the reality of them. Still, I feel that awareness is an essential ingredient in targeting this devastating issue. This is truly a situation in which putting your head in the sand can make a life or death difference. I deal with domestic violence in my office frequently. I have a confidential questionnaire that each patients fills out with her visit that starts off with some generalized questions and slowly leads up to questions about domestic violence. This way, she can fill it out confidentially and then we can open up a dialogue once she is safely back in an exam room. Sometimes, I am the first person who has ever even asked the question in her whole life. These are often women who have friends, relatives etc who have seen bruises or noticed behaviors but don’t consider it their place or are afraid to mention it for fear of repercussions and or potential danger to themselves.

I think that sometimes abuse victims face a culture of blame. Myths about domestic violence are common, particularly among those who are likely to abuse their partners. Some people say that if they get hit, they will hit back and then the next bit of twisted logic is that women who slap their partners should expect whatever violence their partner can dish out because they deserve it. I hear women say that they got ” what was coming to them” as a result of a particular behavior. This is false! There is no behavior that justifies physical violence or emotional abuse. All of these myths contribute to an overall culture of violence and victim-shaming.

People talk about the victim as being a part of the cycle of abuse and have no idea why the person doesn’t leave the relationship. This is an easy statement to make on the outside, but these same people are not intimately involved in that relationship. They don’t realize what is potentially at stake with leaving. Sometimes there are children involved and the victim feels that they will be more at risk with leaving. Sometimes there is a very real danger that the victim themselves may be killed if they try to leave. Sometimes the victim cannot leave because their partner offers financial security. Victims talk about the very strong psychological pull of the ” honeymoon period.” The honeymoon period is that period of calm when things appear good again and the abuser has apologize and made temporary changes and restored the often desperate and fleeting hope that the victim has that the relationship can be saved. I have patients tell me that this honeymoon period is all that have to live for at certain points because they are so broken by the abuse and the relationship that they can no longer see or evaluate their lives clearly.

So, how do you spot an abusive relationship? What are the signs?

1. Humiliating or embarrassing you

2. Constant put-downs

3. Hypercriticism

4. Refusing to communicate

5. ignoring or excluding you

6. Affairs with other people

7. Provocative behavior with the opposite sex

8. Unreasonable jealousy

9. Extreme moodiness

10.Mean jokes or making fun of you

11.saying ” I love you, but…

12. Guilt trips

13. Domination and control

14. Making everything your fault

15. Withdrawal of affection

16. Isolating you from friends and family

17. Using money to control

18. Constant calling or texting when you are not with them

19. Threatening to commit suicide if you leave

Ok now that you know the signs. What do you do about it? What do you do when you notice it in someone else’s relationship? If you are the victim, the obvious, but not easy, answer is to break off the relationship and leave. Call the National Domestic Violence Hotline at 1-800-799-SAFE. All phone calls are confidential. This is a 24 hour hotline to talk confidentially with anyone in the United States who is experiencing domestic violence, seeking information, or questioning if his or her relationship is unhealthy. This same hotline also provides lifesaving tools and immediate support to empower victims and survivors and also provides support to friends and family. They have an online chat as well if you do not feel comfortable or are unable to call. If you are the observer, don’t wait for the victim to approach you. Ask them in private and let them know your concerns. Tactfully point out the signs that you have noticed. Offer to be there for them to talk and promise confidentiality. Direct the victim toward resources such as the national hotline. You could save a life. Have a fantastic day!

Dr. Katz